A dictionary of practical surgery: comprehending all the most interesting improvements up to the present period: also an account of the instruments, remedies, and applications employed in surgery; the etymology and signification of the principal terms; a copious bibliotheca chirurgica; and a variety of original facts and observations / [Samuel Cooper].

  • Cooper, Samuel, 1780-1848.
Date:
1818
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical surgery: comprehending all the most interesting improvements up to the present period: also an account of the instruments, remedies, and applications employed in surgery; the etymology and signification of the principal terms; a copious bibliotheca chirurgica; and a variety of original facts and observations / [Samuel Cooper]. Source: Wellcome Collection.

    12/1134 (page 4)
    With respect to the particular merit of this invention, it certainly possesses the recommendation of ingenuity; but, it operates much in the same manner, as several other mechanical contrivances, the serrenceud of Desault, the presseartere of Deschamps, the pincers of Baron Percy, &c. If there be a real advantage in the division of the internal coats of an artery by the li- gature, as the experiments of Jones seem to prove, and as many of the best surgeons in this country inculcate (See Hemorrhage and Ligature), then the compressor cannot be an eligible means of obliterating an artery. It may be said, however, that experience has proved its efficacy; but, let it be re- collected, that almost every method of operating for aneurisms has some- times answered. Further experience is requisite to determine, whether Assalini’s compressor would succeed as often as, or more frequently, than, the scientific application of the right kind of ligatures (See Ligature) which may perhaps seem slower in their effect, only because they are not in ge- neral removed as early as Signor Assalini’s instrument. At the same time, it ■must be acknowledged, that the latter admits of being loosened, tightened again, or taken away, according as circumstances may indicate, with the utmost convenience, and without the slightest disturbance of the artery. Perhaps, however, experience may ultimately decide, that, in cases of aneurism, it will be best to follow the method of tying the artery with a very small silk ligature, the whole of which is immediately afterw ards to be cut off with the exception of the noose and knot, and an endeavour then made to heal the wound by the first intention. On this point, however, the present state of our knowledge will only allow us to speak with dif- fidence. My friend Mr. Lawrence lately informed me of an example, in which a surgical acquaintance of his in the country had actually adopted the plan with perfect success; the wound having united without any suppuration. In some parts of this Dictionary, had they not been already printed, I should have referred to the late memorable case, in which the aorta itself of the human subject was tied by Mr. Astley Cooper, in Guy’s Hospital. The patient had an aneurism in the groin, extending so far within the body, that the operation of taking up the external iliac artery appeared totally im- practicable. The tumour had already burst, and the patient was on the point of losing his lifeby hemorrhage. In this dilemma, the above distinguished surgeon, ever anxious to enlarge the limits of chirurgical knowledge, deter- mined first to try to get at the source of the bleeding by opening the swelling, and, if nothing could be done in this manner, he resolved to make his way to the aorta, by an incision through the parietes of the abdomen, and then to apply a ligature to this trunk of trunks. Suffice it here to state, that the aorta was tied; that immediate death from hemorrhage was prevented; and, what is above all things interesting, that the circulation went on in the lower extremities. The leg, however, on the same side as the tumour, became cold ; but, the opposite one retained its natural warmth. The man lived thirty-six hours after the operation. With the particulars, how- ever, respecting the symptoms preceding his death, the exact part of the artery tied, and the appearances on dissection, I am not at present acquainted. While I am writing this preface, I observe, thatasecond instance has just been published, in which the internal iliac artery has been tied. The opera- tion was performed by Mr. Atkinson, of York, in a case of gluteal aneurism. The following are a few of the particulars, as related by this gentleman : Tho- mas Cost, aged 29, presented himself at the York County Hospital, April 29th, 1817. He was a tall, strong, active bargeman, not corpulent, but very muscular. He was enduring great pain from a large, renitent, pulsating tumour, situated under the glutaeus of the right side; an obvious aneurism. It had existed about nine months, and was the consequence of a blow from a stone. In a consultation with Dr. Lanson and Dr. Wake, the necessity